KEY POINTS
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A BBC investigation documented at least 43 attacks on hospitals and healthcare sites in el-Fasher between May 2024 and October 2025.
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The investigation recorded 55 medical workers killed, 120 injured and 10 forcibly disappeared or abducted between April 2023 and October 2025.
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The Rapid Support Forces (RSF) denied the findings, while the UN human rights chief said the evidence was deeply disturbing and could point to violations of international humanitarian law.
A BBC investigation has uncovered evidence that Sudan’s paramilitary Rapid Support Forces systematically attacked hospitals and other healthcare facilities during the siege and eventual takeover of el-Fasher, the capital of North Darfur.
The investigation documented at least 43 separate attacks on hospitals and healthcare sites between May 2024 and October 2025. Some facilities were reportedly struck multiple times, forcing medical workers to close hospitals, relocate patients and move essential services to alternative locations.
The findings cover one of the most devastating periods of Sudan’s civil war, which began in April 2023 when fighting erupted between the RSF and Sudan’s military.
Under international humanitarian law, medical facilities and healthcare workers are generally protected during armed conflict. Deliberate attacks on them may constitute war crimes.
UN High Commissioner for Human Rights Volker Türk described the BBC’s findings as “deeply disturbing”, saying they were consistent with evidence gathered by his office.
The RSF rejected the investigation’s conclusions. Dr Alaa Eldin Nugud, health minister in the RSF-backed civilian administration, dismissed the allegations as propaganda intended to damage the group’s reputation.
Medical Workers Killed, Injured and Abducted
The investigation also documented the toll on healthcare personnel in el-Fasher during the conflict.
BBC data showed that, between April 2023 and October 2025, 55 medical workers were killed, 120 injured and 10 forcibly disappeared or abducted.
Doctors who worked in the city described repeated attacks that disrupted medical services and left civilians with fewer places to receive treatment.
Dr Muhamed Suliman, a surgeon who worked in el-Fasher during the siege, told the BBC that the attacks appeared intended to force hospitals out of operation and make it increasingly difficult for civilians to remain in the city.
The findings highlight the impact of the conflict on patients who depended on hospitals for emergency surgery, maternity care, dialysis and other essential services.
The BBC said it interviewed six doctors who described what they believed was a pattern of systematic attacks on healthcare facilities.
South Hospital Raided as Fighting Intensified
Several medical facilities in el-Fasher had closed within weeks of the civil war beginning in April 2023. These included the Teaching Hospital, one of the city’s main medical centres, which was situated in a conflict zone.
Services were transferred to South Hospital, where medical staff continued treating patients despite power cuts and dwindling supplies.
The situation deteriorated in late May and early June 2024 as the RSF intensified its siege of the city. South Hospital was shelled several times as paramilitary fighters advanced from eastern positions.
Dr Suliman said medical teams treated 16 injured patients on the day of one of the attacks, when the hospital was particularly crowded because it was the only functioning facility providing surgical services in the city.
The violence escalated on June 8, 2024, when RSF fighters raided the hospital.
Dr Mustafa Ahmed, a pharmaceutical specialist, told the BBC that staff were caught by surprise and that many escaped through a wall at the back of the building.
The hospital’s director general, surgeon Izzeldin Ahmed Dawaud Asow, said he was beaten with rifle butts after fighters confronted him and used ethnic slurs against him. He said he survived by pretending to be dead.
After the Sudanese military and its allies drove the RSF out of the facility that day, Dr Asow returned to find several patients dead and surgical equipment destroyed.
South Hospital later closed and eventually fell under RSF control when the military withdrew.
RSF Disputes Allegations Over Hospital Use
Dr Nugud, the RSF-backed administration’s health minister, argued that South Hospital had been used as a military base.
He claimed missile launchers had been installed on the hospital grounds and presented footage of what he said were remnants of weapons found at the site. He also showed what he described as maps of landmines around the Teaching Hospital, which is next to Sudanese military headquarters.
Under international law, a hospital can lose its special protection if it is used to commit acts harmful to the enemy, subject to specific legal conditions and safeguards.
However, the BBC said it found no independent evidence supporting Dr Nugud’s allegations. Doctors interviewed by the broadcaster disputed the claim that South Hospital had been incorporated into a military base.
The competing accounts underline the difficulty of independently verifying events in an active conflict, particularly when access to affected areas is limited.
Saudi Hospital Repeatedly Hit
After South Hospital closed, medical staff and remaining equipment were transferred to the Saudi Maternity Hospital in western el-Fasher, near the military’s main bases.
The BBC investigation found that attacks on the facility increased within days of the relocation.
Médecins Sans Frontières, the international medical charity, raised concerns at the time, saying it could not determine whether hospitals were being deliberately targeted but warning that parties to the conflict were failing to take adequate precautions to protect them.
Doctors later told the BBC that Saudi Hospital was repeatedly struck by shelling and drone attacks. Some said the facility was hit as many as 25 times in a single day.
Smaller hospitals and neighbourhood clinics were also attacked, according to the investigation. In some cases, medical services were relocated to alternative buildings, only for those locations to come under fire as well.
The Specialised Children’s Hospital moved twice after its original location closed, but both replacement sites were reportedly shelled and forced to shut. The city’s main dialysis centre was also attacked and struck again after relocating.
By the time the RSF captured el-Fasher in October 2025, Saudi Hospital was reportedly the only functioning health facility left in the city.
Doctors Used Makeshift Theatres to Continue Treating Patients
As conditions worsened, medical staff attempted to keep treating patients by reinforcing buildings with sandbags, constructing underground shelters from steel containers and establishing alternative locations for patient care and surgery.
Dr Asow said the makeshift surgical facility was attacked five times in 2025.
He recalled an incident in which an explosion shook the building while he was operating on a patient’s neck. Other medical workers fled in fear, but he remained.
In another incident, he said he instructed staff to move a patient to another location because the operating theatre needed a thorough cleaning after an intense workload. The original theatre was subsequently destroyed by shelling, and the patient survived.
Doctors also described attacks on people transporting the injured. Dr Asow told the BBC that on March 15, 2025, a drone followed people carrying injured patients towards a temporary ward before striking near its entrance, killing nine people.
He also said a donkey cart carrying patients to an alternative operating theatre was hit by a drone on August 17, killing two patients and the driver, as well as the animal. The account came from Dr Asow and was not independently confirmed in the supplied report.
